Period of communicability Up to years

Occurrence and distribution P. westermani disease is found mainly in China, other parts of Asia, Africa and the Americas. Closely related species are P. africanus and P. uterobilateralis in West Africa, P. pulmonalis in Japan, Korea and Taiwan, P. philippinensis in the Philippines, P. het-erotremus in Thailand and Laos, P. kellicotti, P. caliensis and P. mexicanus in Central and South America. In all, it has been calculated that some 30 million people suffer from the lung fluke.

Control and prevention Control is most effectively achieved by ensuring that all crab and crayfish meat is properly cooked. Much can be achieved by teaching people about the life cycle of this and other trematode infections, stressing that all food must be cooked and faeces disposed of properly. Spitting should be outlawed.

Treatment is by praziquantel 25 mg/kg three times a day for 2 consecutive days. Alternatively, triclabendazole 10 mg/kg, repeated in 12 h, can be used.

Surveillance It is a focal disease so that identifying a case will often lead to a foci of infection and preventive action can then be instituted.

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